Abstract
The results of empirical trials with proton pump inhibitors (PPIs) for management of gastroesophageal reflux-induced chronic cough (GERC) have resulted in considerable controversy and the mechanism of PPI refractoriness remain unclear. In total, 128 GERC patients were enrolled between March 2018 and October 2022. The post-reflux swallow-induced peristaltic wave index (PSPWI) was lower in the PPI-refractory group than the PPI-responsive group (33.89±7.38versus39.45±9.47, respectively, p<0.001), as were the mean nocturnal baseline impedance (MNBI) and proximal MNBI [2092.11 (IQR: 652.23)]versus2426.52 (IQR: 917.39) Ω, respectively, p=0.012; 1599.50 (IQR: 1206.63)versus2274.50 (IQR: 1775.29) Ω, respectively, p=0.001). Multivariate logistic regression analysis identified the PSPWI (odds ratio=0.919, p=0.001) as an independent predictor of PPI-refractory GERC. The diagnostic value of both proximal MNBI≤39.90% and MNBI≤2233.58 Ω had moderate sensitivity (71.67%) and specificity (75.00%) to identify PPI-refractory GERC.
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